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Date of last update: 10/17/2017.

Forum Name: Endocrinology Topics

Question: Can you help me as to whether this is adrenal insufficiency?

 thezoo17 - Sat Nov 27, 2004 1:48 am


I am hoping I can get some advice.

I have been to many many different kinds of doctors and now I am so confused. One says this and the others say something else. I don't know which ones to believe.

I am almost 40 years old. Ever since I was 13 I get extremely exhausted everyday at the same time, worse if I have had a stressful day. I used to take a nap every day after school and then as the years past I took a nap every day after work (which was before 5 pm). But in the past 10 years I work past 5 pm and at 5 pm that is when the exhaustion hits me hard to where I need to sleep and if not I feel as if I am going to die.
So anyway, for the past 10 years I am unable to take a nap because of my work hours and by pushing myself beyond the 5 pm mark (when the exhaustion hits) I have developed fibromylgia (according to a fibro specialist -Dr Pellegrino).

I have been trying to find a reason why I get so darn exhausted after only being up for 8 hours. I have spent thousands of dollars and alot of time on this and I still don't have any real clue.
I had a ACTH stim test done. Also a random cortisol test. So many other different tests also.

Here are my results from the random cortisol test at
6 pm. -- 5.5 (range 3-22 AM)
(range 1-16.7 PM)

ACTH Stim test: 8 am. -- 16.6 (range 3.8-14.4)
1 hour later 20.3 (range 3.8-14.4)
1 hour later 24.2 (range 3.8-14.4)

Adreno. Hormone 8 am. -- 37 (range 7-10am: 9-52)
1 hour later 49 (same as above)
1 hour later 19 (same as above)

Saliva Cortisol: Morning -- 12.5 (range 13.0 -24.0)
Noon -- 4.7 (range 5.0-7.0)
Afternoon -- 2.1 (range 4.0-7.0)
Nighttime -- 1.2 (range 1.0-3.0)
Cortisol sum: 20.5 (range 23.0-42.0)
DHEAs Average 1.3 (range 2.0-10.0)

I am current seeing a DO who is treating me for low ratio of Estradiol/Progesterone. She says that my cortisol should rise
once I am on this cream for awhile, well its been 4 months and I still don't feel any better.
I am also in alot of muscle pain in the neck and shoulders, I am constipated every day, maybe have a bowel movement once a week if I am lucky, blood shot eyes after being awake for 8 hours also very small pupils, poor concentration, foggy, foggy head and extremely exhausted.

I also am seeing a sleep specialist, I have sleep apnea and PLDM and am on 30mg of Remeron. I have been on this for about 2 months now and I am slighty better in the foggy head area but thats it.

Do you think my cortisol levels are ok? Or should I continue to find a doctor that will treat low cortisol?

Any advice would greatly be appreciated !!!

Thank you so much for listening!

Tired and worn out and about ready to give up at almost 40 years old!

 DaveT - Sat Nov 27, 2004 2:09 am

I don't know too much about this, but I have heard very similar symptoms from Chronic Fatigue Syndrome. I think I even read somewhere that CFS and Fibromyalgia are often misdiagnosed or confused as each other. You should look into that.
 AtlantaCCN - Mon Nov 29, 2004 11:56 am

Hi Joyce, the ratio of average cortisol to DHEA puts you in area 4, which according to DiagnosTechs scheme is adrenal maladaptation phase II. Nutritional Protocols to deal with this would include (from Apex Energetics products): Glysen to manage sugar metabolism, Adaptocrine, Adrenocalm, and fatty acids such as DHA, EPA and some GLA. Standard Process has a slightly different protocol. ASk your DO to contact Apex Energetics and ask for seminar info by Datis Kharrazian DC (and numerous other degrees)

rebuilding estrogen/progesterone will help, but the metabolic pathway goes farther back, to cholesterol and its derivatives, vital VITAL for building adrenal cortex substances such as cortisol, DHEA, and the sex hormones, also CoQ10. Phosphatidyl serine is an important support ingredient here too.

meanwhile absolutely avoid anything with caffeine such as coffee, colas. Serious B vitamin therapy, vita min C complex, CoQ10 , and a completely clean diet (recognizable as if it had come straight from the garden (OK to have washed it off), NOTHING from a cardboard or plastic container with ingredient lists on it. You might try powdered green vegetables such as Perfect Food, Just Barley, Best of Greens, small amounts 1/4 tsp twice a day to start, then increase the amount

sounds like a need also for balancing your amino acids, rebuilding nutrient supply on a grand scale. again, LOTS of veggies, also some fish, NO fake food. Swaroopa yoga and a SAD or full spectrum light might be helpful too. Hope this helps, Karen

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